Jurisdiction F Part B LCDs and LCAs - Effective November 1, 2019

The Jurisdiction F Part B Local Coverage Determination (LCDs) and Local Coverage Articles (LCAs) have been created and published for notice under contract numbers: 02102 (AK), 02202 (ID), 02302 (OR), 02402 (WA), 03102 (AZ), 03202 (MT), 03302 (ND), 03402 (SD), 03502 (UT), 03602 (WY).

Change Request 10901, dated February 12, 2019, and the 21st Century Cures Act require all coding (procedure, diagnosis, modifier, revenue, and type of bill) to be removed from LCDs and placed into billing and coding articles. There is no change in coverage. See the LCD title, Medicare Coverage Database (MCD) LCD number and the MCD article number below.

All LCD LCAs will be titled "Billing and Coding: LCD Title."

Effective Date: November 1, 2019

MCD LCD Number MCD LCA Number LCD Title
L37549 A57498 Chest X-Ray Policy
L37738 A57513 Magnetic-Resonance-Guided Focused Ultrasound Surgery (MRgFUS) for Essential Tremor
L36857 A57613 Measurement of Salivary Hormones
L37122 A57337 MolDX: 4Kscore Assay
L37358 A57457 MolDX: AlloSure® Donor-Derived Cell-Free DNA Test
L36884 A57353 MolDX: APC and MUTYH Gene Testing
L37062 A57357 MolDX: BDX-XL2
L36163 A57355 MolDX: BRCA1 and BRCA2 Genetic Testing
L36386 A57364 MolDX: Breast Cancer Assay: Prosigna
L36329 A57606 MolDX: ConfirmMDx Epigenetic Molecular Assay
L37675 A57416 MolDX: Corus® CAD Assay
L36312 A57522 MolDX: CYP2C19, CYP2D6, CYP2C9, and VKORC1 Genetic Testing
L37618 A57644 MolDX: Cystatin C Measurement
L37820 A57646 MolDX: Decipher® Biopsy Prostate Cancer Classifier Assay for Men with Very Low and Low Risk Disease
L36345 A57624 MolDX: Decipher® Prostate Cancer Classifier Assay
L37748 A57418 MolDX: DecisionDx-Melanoma
L37072 A57622 MolDX: DecisionDx-UM (Uveal Melanoma)
L37311 A57608 MolDX: EndoPredict® Breast Cancer Gene Expression Test
L37891 A57420 MolDX: Envisia, Veracyte, Idiopathic Pulmonary Fibrosis Diagnostic Test
L36325 A57525 MolDX: GeneSight® Assay for Refractory Depression
L36186 A57422 MolDX: Genetic Testing for BCR-ABL Negative Myeloproliferative Disease
L36159 A57424 MolDX: Genetic Testing for Hypercoagulability / Thrombophilia (Factor V Leiden, Factor II Prothrombin, and MTHFR)
L36374 A54996 MolDX: Genetic Testing for Lynch Syndrome
L36368 A57464 MolDX: Genomic Health™ Oncotype DX® Prostate Cancer Assay
L37651 A57426 MolDX: Guardant360® Plasma-Based Comprehensive Genomic Profiling in Non-Small Cell Lung Cancer (NSCLC)
L36149 A57468 MolDX: HLA-B*15:02 Genetic Testing
L37899 A57665 MolDX: Inivata, InVisionFirst, Liquid Biopsy for Patients with Lung Cancer
L37622 A57662 MolDX: MDS FISH
L36192 A57433 MolDX: MGMT Promoter Methylation Analysis
L36256 A57527 MolDX: Molecular Diagnostic Tests (MDT)
L36171 A57445 MolDX: Molecular RBC Phenotyping
L36569 A57616 Treatment of Males with Low Testosterone


Visit the Active LCDs webpage to view the locally hosted Active LCD or access it via the CMS MCD.

Visit the Noridian Medicare Coverage Articles webpage to view the complete listing of locally hosted coverage articles and/or access the Active, Future, or Retired articles available in the CMS MCD.


Last Updated Nov 05, 2019